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PEPTIC ULCER DISEASE NRS452 Norhaini Majid.

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Presentation on theme: "PEPTIC ULCER DISEASE NRS452 Norhaini Majid."— Presentation transcript:

1 PEPTIC ULCER DISEASE NRS452 Norhaini Majid

2 Introduction PUD ,a break in a mucous lining of GI tract
Duodenal - most common, age Gastric Ulcer – affect older age

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6 Risk Factors H.pylori infection – how? Use of NSAIDs Cigarette smoking
Family history of PUD Other possible risks – physiological stress, alcohol /caffeine consumption

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8 Pathophysiology Normal gastric mucosa Disruption of mucosal barrier
Inflammatory process Erosion and ulcer formation Refer page , Med/Surg Nsg

9 Manifestation of PUD Classic symptom? Typically described as …….
Occurs Stomach 3 – 4 hours after meal midnight

10 Manifestation of PUD (cont…)
Heartburn Vomit Older adult Chest pain Dysphagia Weight loss Anemia

11 Manifestation of PUD complications
Hemorrhage Obstruction Perforation

12 Hemorrhage Occult blood in stool Hematemesis Fatigue
Weakness, dizziness Orthostatic hypotension Hypovolemic shock

13 Obstruction Sensations of epigastric fullness Nausea & vomiting
Electrolyte imbalances Metabolic alkalosis

14 Perforation Severe upper abdominal pain – shoulder
Rigid, boardlike abdomen Absence of bowel sounds Diaphoresis Tachycardia Rapid, shallow respiration Fever

15 Zollinger-Ellison Syndrome
PUD cause by gastrinoma or gastrin-secreting tumor (pancreas, stomach, or intestine Gastrin ? Affect stomach, duodenum, esophagus and jejunum

16 Zollinger-Ellison Syndrome Characteristic
Ulcer-like pain Diarrhea Steatorrhea

17 Zollinger-Ellison Syndrome Complication
Perforation Bleeding Fluid & electrolyte imbalances

18 Diagnostic Tests Barium Swallow Gastroscopy Biopsy Serologic test
Urea breath test Zollinger-Ellison Syndrome Gastric Analysis

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22 Medications Combination therapy
Two antibiotics + proton pump inhibitors (e.g omeperazole, metronidazole and clarithromycin)

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24 Treatments Dietary mx Surgery Rx of complications

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26 Treatment of Peptic Ulcer Disease
Goals of Treatment Relieve pain Prevent complications (bleeding, perforation, penetration, obstruction) Minimize recurrences Reduce financial costs

27 Nursing Care? Student Activity
Identify nursing problem and solve it using nursing process approach Discuss


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